|
CALCIUM GLUCONATE (BULK) POWDER
|
Facility
|
OP
|
$3.75
|
|
|
Service Code
|
NDC 09900000980
|
| Hospital Charge Code |
1316
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna American Axle |
$2.44
|
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: Aetna Medicare |
$1.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.44
|
| Rate for Payer: BCBS Complete |
$1.50
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cofinity Advantage |
$2.62
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: Priority Health SBD |
$2.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.44
|
| Rate for Payer: UHC Core |
$1.95
|
| Rate for Payer: UHC Exchange |
$1.47
|
| Rate for Payer: UMR Bronson Commercial |
$1.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
CALCIUM GLUCONATE (BULK) POWDER
|
Facility
|
IP
|
$366.00
|
|
|
Service Code
|
NDC 38779182608
|
| Hospital Charge Code |
1316
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.04 |
| Max. Negotiated Rate |
$329.40 |
| Rate for Payer: Aetna American Axle |
$237.90
|
| Rate for Payer: Aetna Commercial |
$311.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.90
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cofinity Advantage |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$314.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.80
|
| Rate for Payer: Healthscope Commercial |
$329.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: PHP Commercial |
$311.10
|
| Rate for Payer: Priority Health SBD |
$230.58
|
| Rate for Payer: UMR Bronson Commercial |
$161.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.50
|
|
|
CALCIUM GLUCONATE (BULK) POWDER
|
Facility
|
IP
|
$3.75
|
|
|
Service Code
|
NDC 09900000980
|
| Hospital Charge Code |
1316
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna American Axle |
$2.44
|
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.44
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cofinity Advantage |
$2.62
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: Priority Health SBD |
$2.36
|
| Rate for Payer: UMR Bronson Commercial |
$1.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
CALCIUM POLYCARBOPHIL 625 MG TABLET
|
Facility
|
IP
|
$120.56
|
|
|
Service Code
|
NDC 00904250091
|
| Hospital Charge Code |
11046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$108.50 |
| Rate for Payer: Aetna American Axle |
$78.36
|
| Rate for Payer: Aetna Commercial |
$102.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.36
|
| Rate for Payer: Cash Price |
$96.45
|
| Rate for Payer: Cofinity Advantage |
$84.39
|
| Rate for Payer: Cofinity Commercial |
$103.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.45
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.42
|
| Rate for Payer: PHP Commercial |
$102.48
|
| Rate for Payer: Priority Health SBD |
$75.95
|
| Rate for Payer: UMR Bronson Commercial |
$53.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.42
|
|
|
CALCIUM POLYCARBOPHIL 625 MG TABLET
|
Facility
|
IP
|
$122.67
|
|
|
Service Code
|
NDC 00536430611
|
| Hospital Charge Code |
11046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.97 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Aetna American Axle |
$79.74
|
| Rate for Payer: Aetna Commercial |
$104.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.74
|
| Rate for Payer: Cash Price |
$98.14
|
| Rate for Payer: Cofinity Advantage |
$85.87
|
| Rate for Payer: Cofinity Commercial |
$105.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.14
|
| Rate for Payer: Healthscope Commercial |
$110.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.00
|
| Rate for Payer: PHP Commercial |
$104.27
|
| Rate for Payer: Priority Health SBD |
$77.28
|
| Rate for Payer: UMR Bronson Commercial |
$53.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.00
|
|
|
CALCIUM POLYCARBOPHIL 625 MG TABLET
|
Facility
|
OP
|
$120.56
|
|
|
Service Code
|
NDC 00904250091
|
| Hospital Charge Code |
11046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.61 |
| Max. Negotiated Rate |
$108.50 |
| Rate for Payer: Aetna American Axle |
$78.36
|
| Rate for Payer: Aetna Commercial |
$102.48
|
| Rate for Payer: Aetna Medicare |
$60.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.36
|
| Rate for Payer: BCBS Complete |
$48.22
|
| Rate for Payer: Cash Price |
$96.45
|
| Rate for Payer: Cofinity Advantage |
$84.39
|
| Rate for Payer: Cofinity Commercial |
$103.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.45
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.42
|
| Rate for Payer: PHP Commercial |
$102.48
|
| Rate for Payer: Priority Health SBD |
$75.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.36
|
| Rate for Payer: UHC Core |
$62.81
|
| Rate for Payer: UHC Exchange |
$47.38
|
| Rate for Payer: UMR Bronson Commercial |
$44.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.42
|
|
|
CALCIUM POLYCARBOPHIL 625 MG TABLET
|
Facility
|
OP
|
$122.67
|
|
|
Service Code
|
NDC 00536430611
|
| Hospital Charge Code |
11046
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.39 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Aetna American Axle |
$79.74
|
| Rate for Payer: Aetna Commercial |
$104.27
|
| Rate for Payer: Aetna Medicare |
$61.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.74
|
| Rate for Payer: BCBS Complete |
$49.07
|
| Rate for Payer: Cash Price |
$98.14
|
| Rate for Payer: Cofinity Advantage |
$85.87
|
| Rate for Payer: Cofinity Commercial |
$105.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.14
|
| Rate for Payer: Healthscope Commercial |
$110.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.00
|
| Rate for Payer: PHP Commercial |
$104.27
|
| Rate for Payer: Priority Health SBD |
$77.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.74
|
| Rate for Payer: UHC Core |
$63.91
|
| Rate for Payer: UHC Exchange |
$48.21
|
| Rate for Payer: UMR Bronson Commercial |
$45.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.00
|
|
|
CAMPHOR 4 %-METHYL SALICYLATE 30 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$16.79
|
|
|
Service Code
|
NDC 96295013062
|
| Hospital Charge Code |
103884
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.21 |
| Max. Negotiated Rate |
$15.11 |
| Rate for Payer: Aetna American Axle |
$10.91
|
| Rate for Payer: Aetna Commercial |
$14.27
|
| Rate for Payer: Aetna Medicare |
$8.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.91
|
| Rate for Payer: BCBS Complete |
$6.72
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Cofinity Advantage |
$11.75
|
| Rate for Payer: Cofinity Commercial |
$14.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.43
|
| Rate for Payer: Healthscope Commercial |
$15.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.59
|
| Rate for Payer: PHP Commercial |
$14.27
|
| Rate for Payer: Priority Health SBD |
$10.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.91
|
| Rate for Payer: UHC Core |
$8.75
|
| Rate for Payer: UHC Exchange |
$6.60
|
| Rate for Payer: UMR Bronson Commercial |
$6.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.59
|
|
|
CAMPHOR 4 %-METHYL SALICYLATE 30 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$16.79
|
|
|
Service Code
|
NDC 96295013062
|
| Hospital Charge Code |
103884
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$15.11 |
| Rate for Payer: Aetna American Axle |
$10.91
|
| Rate for Payer: Aetna Commercial |
$14.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.91
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Cofinity Advantage |
$11.75
|
| Rate for Payer: Cofinity Commercial |
$14.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.43
|
| Rate for Payer: Healthscope Commercial |
$15.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.59
|
| Rate for Payer: PHP Commercial |
$14.27
|
| Rate for Payer: Priority Health SBD |
$10.58
|
| Rate for Payer: UMR Bronson Commercial |
$7.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.59
|
|
|
CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION
|
Facility
|
IP
|
$19.98
|
|
|
Service Code
|
NDC 70000054601
|
| Hospital Charge Code |
23063
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$17.98 |
| Rate for Payer: Aetna American Axle |
$12.99
|
| Rate for Payer: Aetna Commercial |
$16.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.99
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Advantage |
$13.99
|
| Rate for Payer: Cofinity Commercial |
$17.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$17.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.98
|
| Rate for Payer: PHP Commercial |
$16.98
|
| Rate for Payer: Priority Health SBD |
$12.59
|
| Rate for Payer: UMR Bronson Commercial |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION
|
Facility
|
OP
|
$19.98
|
|
|
Service Code
|
NDC 70000054601
|
| Hospital Charge Code |
23063
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$17.98 |
| Rate for Payer: Aetna American Axle |
$12.99
|
| Rate for Payer: Aetna Commercial |
$16.98
|
| Rate for Payer: Aetna Medicare |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.99
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: Cash Price |
$15.98
|
| Rate for Payer: Cofinity Advantage |
$13.99
|
| Rate for Payer: Cofinity Commercial |
$17.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$17.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.98
|
| Rate for Payer: PHP Commercial |
$16.98
|
| Rate for Payer: Priority Health SBD |
$12.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.99
|
| Rate for Payer: UHC Core |
$10.41
|
| Rate for Payer: UHC Exchange |
$7.85
|
| Rate for Payer: UMR Bronson Commercial |
$7.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.98
|
|
|
CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION
|
Facility
|
OP
|
$20.98
|
|
|
Service Code
|
NDC 00536126812
|
| Hospital Charge Code |
23063
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$18.88 |
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna Medicare |
$10.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: BCBS Complete |
$8.39
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.64
|
| Rate for Payer: UHC Core |
$10.93
|
| Rate for Payer: UHC Exchange |
$8.25
|
| Rate for Payer: UMR Bronson Commercial |
$7.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
|
|
CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION
|
Facility
|
IP
|
$20.98
|
|
|
Service Code
|
NDC 00536126812
|
| Hospital Charge Code |
23063
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$18.88 |
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
|
|
CANAKINUMAB (PF) 150 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$58,295.88
|
|
|
Service Code
|
HCPCS J0638
|
| Hospital Charge Code |
182380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$78.23 |
| Max. Negotiated Rate |
$52,466.29 |
| Rate for Payer: Aetna American Axle |
$37,892.32
|
| Rate for Payer: Aetna Commercial |
$49,551.50
|
| Rate for Payer: Aetna Medicare |
$155.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37,892.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.96
|
| Rate for Payer: BCBS Complete |
$82.14
|
| Rate for Payer: BCBS MAPPO |
$149.57
|
| Rate for Payer: BCBS Trust/PPO |
$479.04
|
| Rate for Payer: BCN Commercial |
$479.04
|
| Rate for Payer: BCN Medicare Advantage |
$149.57
|
| Rate for Payer: Cash Price |
$46,636.70
|
| Rate for Payer: Cash Price |
$46,636.70
|
| Rate for Payer: Cofinity Advantage |
$40,807.12
|
| Rate for Payer: Cofinity Commercial |
$50,134.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46,636.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.57
|
| Rate for Payer: Healthscope Commercial |
$52,466.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40,807.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43,721.91
|
| Rate for Payer: Mclaren Medicaid |
$149.57
|
| Rate for Payer: Mclaren Medicare |
$149.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.05
|
| Rate for Payer: Meridian Medicaid |
$157.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,551.50
|
| Rate for Payer: Nomi Health Commercial |
$448.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43,721.91
|
| Rate for Payer: PACE Medicare |
$142.09
|
| Rate for Payer: PACE SWMI |
$149.57
|
| Rate for Payer: PHP Commercial |
$49,551.50
|
| Rate for Payer: PHP Medicare Advantage |
$149.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$446.61
|
| Rate for Payer: Priority Health Medicare |
$149.57
|
| Rate for Payer: Priority Health SBD |
$36,726.40
|
| Rate for Payer: Priority Health Tiered Network |
$357.29
|
| Rate for Payer: Railroad Medicare Medicare |
$149.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.77
|
| Rate for Payer: UHC Core |
$243.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.57
|
| Rate for Payer: UHC Exchange |
$243.77
|
| Rate for Payer: UHC Medicaid |
$78.23
|
| Rate for Payer: UHCCP Medicaid |
$78.23
|
| Rate for Payer: UMR Bronson Commercial |
$21,569.48
|
| Rate for Payer: VA VA |
$149.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43,721.91
|
|
|
CANDIDA ALBICANS SKIN TEST FDA STANDARD INTRADERMAL
|
Facility
|
IP
|
$1,041.60
|
|
|
Service Code
|
NDC 59584013801
|
| Hospital Charge Code |
115385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$458.30 |
| Max. Negotiated Rate |
$937.44 |
| Rate for Payer: Aetna American Axle |
$677.04
|
| Rate for Payer: Aetna Commercial |
$885.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.04
|
| Rate for Payer: Cash Price |
$833.28
|
| Rate for Payer: Cofinity Advantage |
$729.12
|
| Rate for Payer: Cofinity Commercial |
$895.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.28
|
| Rate for Payer: Healthscope Commercial |
$937.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$729.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.20
|
| Rate for Payer: PHP Commercial |
$885.36
|
| Rate for Payer: Priority Health SBD |
$656.21
|
| Rate for Payer: UMR Bronson Commercial |
$458.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.20
|
|
|
CANDIDA ALBICANS SKIN TEST FDA STANDARD INTRADERMAL
|
Facility
|
OP
|
$1,041.60
|
|
|
Service Code
|
NDC 59584013801
|
| Hospital Charge Code |
115385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$385.39 |
| Max. Negotiated Rate |
$937.44 |
| Rate for Payer: Aetna American Axle |
$677.04
|
| Rate for Payer: Aetna Commercial |
$885.36
|
| Rate for Payer: Aetna Medicare |
$520.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.04
|
| Rate for Payer: BCBS Complete |
$416.64
|
| Rate for Payer: Cash Price |
$833.28
|
| Rate for Payer: Cofinity Advantage |
$729.12
|
| Rate for Payer: Cofinity Commercial |
$895.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.28
|
| Rate for Payer: Healthscope Commercial |
$937.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$729.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$833.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.20
|
| Rate for Payer: PHP Commercial |
$885.36
|
| Rate for Payer: Priority Health SBD |
$656.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.04
|
| Rate for Payer: UHC Core |
$542.67
|
| Rate for Payer: UHC Exchange |
$409.35
|
| Rate for Payer: UMR Bronson Commercial |
$385.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.20
|
|
|
CANGRELOR 50 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,270.57
|
|
|
Service Code
|
HCPCS C9460
|
| Hospital Charge Code |
174562
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$2,943.51 |
| Rate for Payer: Aetna American Axle |
$2,125.87
|
| Rate for Payer: Aetna Commercial |
$2,779.98
|
| Rate for Payer: Aetna Medicare |
$20.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,125.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.02
|
| Rate for Payer: BCBS Complete |
$10.99
|
| Rate for Payer: BCBS MAPPO |
$20.02
|
| Rate for Payer: BCBS Trust/PPO |
$57.89
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: BCN Medicare Advantage |
$20.02
|
| Rate for Payer: Cash Price |
$2,616.46
|
| Rate for Payer: Cash Price |
$2,616.46
|
| Rate for Payer: Cofinity Advantage |
$2,289.40
|
| Rate for Payer: Cofinity Commercial |
$2,812.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,616.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$2,943.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,289.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,452.93
|
| Rate for Payer: Mclaren Medicaid |
$20.02
|
| Rate for Payer: Mclaren Medicare |
$20.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.02
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,779.98
|
| Rate for Payer: Nomi Health Commercial |
$60.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,452.93
|
| Rate for Payer: PACE Medicare |
$19.02
|
| Rate for Payer: PACE SWMI |
$20.02
|
| Rate for Payer: PHP Commercial |
$2,779.98
|
| Rate for Payer: PHP Medicare Advantage |
$20.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63.03
|
| Rate for Payer: Priority Health Medicare |
$20.02
|
| Rate for Payer: Priority Health SBD |
$2,060.46
|
| Rate for Payer: Priority Health Tiered Network |
$50.42
|
| Rate for Payer: Railroad Medicare Medicare |
$20.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.90
|
| Rate for Payer: UHC Core |
$32.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.02
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicaid |
$10.47
|
| Rate for Payer: UHCCP Medicaid |
$10.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,210.11
|
| Rate for Payer: VA VA |
$20.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,452.93
|
|
|
CANGRELOR 50 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,270.57
|
|
|
Service Code
|
HCPCS C9460
|
| Hospital Charge Code |
174562
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,439.05 |
| Max. Negotiated Rate |
$2,943.51 |
| Rate for Payer: Aetna American Axle |
$2,125.87
|
| Rate for Payer: Aetna Commercial |
$2,779.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,125.87
|
| Rate for Payer: Cash Price |
$2,616.46
|
| Rate for Payer: Cofinity Advantage |
$2,289.40
|
| Rate for Payer: Cofinity Commercial |
$2,812.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,616.46
|
| Rate for Payer: Healthscope Commercial |
$2,943.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,289.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,452.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,779.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,452.93
|
| Rate for Payer: PHP Commercial |
$2,779.98
|
| Rate for Payer: Priority Health SBD |
$2,060.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,439.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,452.93
|
|
|
CANNABIDIOL 100 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$6,327.00
|
|
|
Service Code
|
NDC 70127010001
|
| Hospital Charge Code |
188582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,340.99 |
| Max. Negotiated Rate |
$5,694.30 |
| Rate for Payer: Aetna American Axle |
$4,112.55
|
| Rate for Payer: Aetna Commercial |
$5,377.95
|
| Rate for Payer: Aetna Medicare |
$3,163.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.55
|
| Rate for Payer: BCBS Complete |
$2,530.80
|
| Rate for Payer: Cash Price |
$5,061.60
|
| Rate for Payer: Cofinity Advantage |
$4,428.90
|
| Rate for Payer: Cofinity Commercial |
$5,441.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.60
|
| Rate for Payer: Healthscope Commercial |
$5,694.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,061.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.25
|
| Rate for Payer: PHP Commercial |
$5,377.95
|
| Rate for Payer: Priority Health SBD |
$3,986.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,112.55
|
| Rate for Payer: UHC Core |
$3,296.37
|
| Rate for Payer: UHC Exchange |
$2,486.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,340.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.25
|
|
|
CANNABIDIOL 100 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$6,327.00
|
|
|
Service Code
|
NDC 70127010010
|
| Hospital Charge Code |
188582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,340.99 |
| Max. Negotiated Rate |
$5,694.30 |
| Rate for Payer: Aetna American Axle |
$4,112.55
|
| Rate for Payer: Aetna Commercial |
$5,377.95
|
| Rate for Payer: Aetna Medicare |
$3,163.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.55
|
| Rate for Payer: BCBS Complete |
$2,530.80
|
| Rate for Payer: Cash Price |
$5,061.60
|
| Rate for Payer: Cofinity Advantage |
$4,428.90
|
| Rate for Payer: Cofinity Commercial |
$5,441.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.60
|
| Rate for Payer: Healthscope Commercial |
$5,694.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,061.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.25
|
| Rate for Payer: PHP Commercial |
$5,377.95
|
| Rate for Payer: Priority Health SBD |
$3,986.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,112.55
|
| Rate for Payer: UHC Core |
$3,296.37
|
| Rate for Payer: UHC Exchange |
$2,486.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,340.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.25
|
|
|
CANNABIDIOL 100 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$6,327.00
|
|
|
Service Code
|
NDC 70127010010
|
| Hospital Charge Code |
188582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,783.88 |
| Max. Negotiated Rate |
$5,694.30 |
| Rate for Payer: Aetna American Axle |
$4,112.55
|
| Rate for Payer: Aetna Commercial |
$5,377.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.55
|
| Rate for Payer: Cash Price |
$5,061.60
|
| Rate for Payer: Cofinity Advantage |
$4,428.90
|
| Rate for Payer: Cofinity Commercial |
$5,441.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.60
|
| Rate for Payer: Healthscope Commercial |
$5,694.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.25
|
| Rate for Payer: PHP Commercial |
$5,377.95
|
| Rate for Payer: Priority Health SBD |
$3,986.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,783.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.25
|
|
|
CANNABIDIOL 100 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$6,327.00
|
|
|
Service Code
|
NDC 70127010001
|
| Hospital Charge Code |
188582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,783.88 |
| Max. Negotiated Rate |
$5,694.30 |
| Rate for Payer: Aetna American Axle |
$4,112.55
|
| Rate for Payer: Aetna Commercial |
$5,377.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.55
|
| Rate for Payer: Cash Price |
$5,061.60
|
| Rate for Payer: Cofinity Advantage |
$4,428.90
|
| Rate for Payer: Cofinity Commercial |
$5,441.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.60
|
| Rate for Payer: Healthscope Commercial |
$5,694.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.25
|
| Rate for Payer: PHP Commercial |
$5,377.95
|
| Rate for Payer: Priority Health SBD |
$3,986.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,783.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.25
|
|
|
CANNABIDIOL 400 MG/4 ML ORAL SYRINGE
|
Facility
|
IP
|
$253.08
|
|
|
Service Code
|
NDC 0990002044
|
| Hospital Charge Code |
302033
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$227.77 |
| Rate for Payer: Aetna American Axle |
$164.50
|
| Rate for Payer: Aetna Commercial |
$215.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.50
|
| Rate for Payer: Cash Price |
$202.46
|
| Rate for Payer: Cofinity Advantage |
$177.16
|
| Rate for Payer: Cofinity Commercial |
$217.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.46
|
| Rate for Payer: Healthscope Commercial |
$227.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.81
|
| Rate for Payer: PHP Commercial |
$215.12
|
| Rate for Payer: Priority Health SBD |
$159.44
|
| Rate for Payer: UMR Bronson Commercial |
$111.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.81
|
|
|
CANNABIDIOL 400 MG/4 ML ORAL SYRINGE
|
Facility
|
OP
|
$253.08
|
|
|
Service Code
|
NDC 0990002044
|
| Hospital Charge Code |
302033
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.64 |
| Max. Negotiated Rate |
$227.77 |
| Rate for Payer: Aetna American Axle |
$164.50
|
| Rate for Payer: Aetna Commercial |
$215.12
|
| Rate for Payer: Aetna Medicare |
$126.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.50
|
| Rate for Payer: BCBS Complete |
$101.23
|
| Rate for Payer: Cash Price |
$202.46
|
| Rate for Payer: Cofinity Advantage |
$177.16
|
| Rate for Payer: Cofinity Commercial |
$217.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.46
|
| Rate for Payer: Healthscope Commercial |
$227.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.81
|
| Rate for Payer: PHP Commercial |
$215.12
|
| Rate for Payer: Priority Health SBD |
$159.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.50
|
| Rate for Payer: UHC Core |
$131.85
|
| Rate for Payer: UHC Exchange |
$99.46
|
| Rate for Payer: UMR Bronson Commercial |
$93.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.81
|
|
|
CAPLACIZUMAB-YHDP 11 MG INJECTION KIT
|
Facility
|
OP
|
$23,177.83
|
|
|
Service Code
|
HCPCS C9047
|
| Hospital Charge Code |
189691
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$419.06 |
| Max. Negotiated Rate |
$20,860.05 |
| Rate for Payer: Aetna American Axle |
$15,065.59
|
| Rate for Payer: Aetna Commercial |
$19,701.16
|
| Rate for Payer: Aetna Medicare |
$833.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,065.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,001.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,001.58
|
| Rate for Payer: BCBS Complete |
$440.05
|
| Rate for Payer: BCBS MAPPO |
$801.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.89
|
| Rate for Payer: BCN Commercial |
$2,635.89
|
| Rate for Payer: BCN Medicare Advantage |
$801.26
|
| Rate for Payer: Cash Price |
$18,542.26
|
| Rate for Payer: Cash Price |
$18,542.26
|
| Rate for Payer: Cofinity Advantage |
$16,224.48
|
| Rate for Payer: Cofinity Commercial |
$19,932.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,542.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.26
|
| Rate for Payer: Healthscope Commercial |
$20,860.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,224.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,383.37
|
| Rate for Payer: Mclaren Medicaid |
$801.26
|
| Rate for Payer: Mclaren Medicare |
$801.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.32
|
| Rate for Payer: Meridian Medicaid |
$841.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$921.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$881.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,701.16
|
| Rate for Payer: Nomi Health Commercial |
$2,403.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17,383.37
|
| Rate for Payer: PACE Medicare |
$761.20
|
| Rate for Payer: PACE SWMI |
$801.26
|
| Rate for Payer: PHP Commercial |
$19,701.16
|
| Rate for Payer: PHP Medicare Advantage |
$801.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,531.02
|
| Rate for Payer: Priority Health Medicare |
$801.26
|
| Rate for Payer: Priority Health SBD |
$14,602.03
|
| Rate for Payer: Priority Health Tiered Network |
$2,024.82
|
| Rate for Payer: Railroad Medicare Medicare |
$801.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,323.71
|
| Rate for Payer: UHC Core |
$1,323.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$801.26
|
| Rate for Payer: UHC Exchange |
$1,323.71
|
| Rate for Payer: UHC Medicaid |
$419.06
|
| Rate for Payer: UHCCP Medicaid |
$419.06
|
| Rate for Payer: UMR Bronson Commercial |
$8,575.80
|
| Rate for Payer: VA VA |
$801.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,383.37
|
|
